Provider Demographics
NPI:1992176382
Name:RATNER, JESSICA (MSS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RATNER
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 SOUTH ST
Mailing Address - Street 2:APT 222
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1344
Mailing Address - Country:US
Mailing Address - Phone:484-802-5830
Mailing Address - Fax:
Practice Address - Street 1:2031 SOUTH ST
Practice Address - Street 2:APT 222
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1344
Practice Address - Country:US
Practice Address - Phone:484-802-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health